Understanding the Lighting Needs of the Aging Eye

Commercial, Indoor

Our world is rapidly aging. In 2006, 11 percent of the global population was 60 and over. It is projected that in 2050, the 60 and over population will increase to 22 percent. For the first time in human history, there are more 60 and over people than children aged 0-14.

So, why is this happening? Many researchers believe this is due to the high fertility after World War II. This high fertility rate is a result of reduced death rates, significant reductions of infectious and parasitic diseases, reductions in infant mortality and improved nutrition.

As we grow older, visual impairments are inevitable. There is an estimated 285 million people worldwide with a visual impairment, with 15 million in the United States alone. With this growing population and number of people with visual impairments, the need for senior care facilities installed with proper lighting is vital.

Changes to Vision

According to the Vision Council, 1 in 28 Americans aged 40 and over already have low vision (20/70 acuity or worse after correction [glasses or surgery]) This will only continue to increase over the next 20 years as 10,000 baby boomers turn 65-years-old each day.

What happens when the eye ages? The lens starts to lose elasticity causing blurred vision and difficulty focusing, and they can also yellow, impacting color perception and decreased recognition of blue hues. Muscles that control the pupil weaken, making it more difficult to adapt from bright to dark spaces, and vice versa. Because of the weakening muscles and decreased size of the pupil, less light is able to enter the eye. This is one reason why the older population requires higher light levels. Another reason is because the number of rods in the eye can decrease as we age, making it more difficult to see in low light.

In addition to these effects, there are also age-related eye diseases: cataracts, glaucoma, macular degeneration, diabetic retinopathy and retinitis pigmentosa.

Cataracts

Most cataracts develop slowly over the course of years. They mainly cause blurry vision and can be like looking through a frosty window. People with cataracts need higher light levels with minimal glare, due to their difficulty seeing in low light and sensitivity to glare.

Glaucoma

Glaucoma is caused when there is damage to the nerve connecting the eye to the brain. This is usually caused by high eye pressure. The main visual symptom is simply slow vision loss. It includes the loss of side vision and reduced contrast. People with glaucoma need high contrast and high light levels.

Macular Degeneration

Macular degeneration causes a loss in the center of the field of vision. There are two types: dry and wet. With dry macular degeneration, the center of the retina deteriorates and wet causes leaky blood vessels to grow under the retina. Most people will encounter blurred vision and need high light levels and direct task lighting.

Diabetic Retinopathy

Diabetic retinopathy is caused by damage to the blood vessels in the tissue at the back of the eye (retina). This can cause floaters, blurriness, dark areas of vision and difficulty differentiating colors. People with retinopathy need high light levels with minimal glare.

Retinitis Pigmentosa

Retinitis pigmentosa is a very rare disease that causes severe vision impairment. Symptoms can begin during childhood and cause reduced vision at night or in low light levels. It can also cause a loss in side vision. People with this condition need high light levels and reduced glare.

How Lighting Affects Lives

Lighting can impact the mood, health and wellbeing of residents in senior care facilities.

Task Visibility

When it comes to task visibility, seniors like to stay busy with reading, crafting and other activities that require a certain amount of light. They need to be able to see to enjoy whatever activity they are doing. By layering lighting in common areas where they partake in these activities, they are provided with optimal lighting.

Visual Performance and Safety

Visual performance and safety can go hand-in-hand. Residents in senior care facilities need to feel independent in doing their everyday tasks. They want to move through the hallways without assistance, and go about their day independently. In order for them to do this, they need proper light levels around the facility to increase their visual performance. Poor visual performance can lead to falls and accidents, which could have a more serious impact on their long-term health. With improper lighting, shadows and glares can be created, also negatively impacting visual performance.

Circadian Rhythm and Psychiatric Wellness

Circadian rhythm plays a significant role in senior care lighting. Some studies have shown that proper lighting can have positive impacts on residents with dementia. Dementia is a progressive disease that causes the decline of mental abilities accompanied by changes in personality. This causes the person’s environment to become more and more confusing. Customized lighting solutions can help with difficulties with recognition and perception as well as difficulties with time and place orientation.

By tuning lighting to match the natural daylighting provided by the sun, sleep-wake cycles are better regulated. A disruption in the body’s circadian rhythm can cause agitation, fatigue and even alter hormone levels. To ensure their circadian rhythms aren’t disrupted, high contents of blue light should be used during the day, and decreased at night. According to a study conducted by the U.S. Department of Energy, there was a 41 percent reduction in yelling, agitation and crying in dementia residents when they were in facilities that utilized custom color tuning lighting systems. These custom lighting systems can also help facilitate the daily routines of healthcare providers.

All of these aspects can then lead to overall resident psychiatric wellness. If the residents are comfortable, have a sense of independence and are safe in their facility, they will maintain a healthy psyche.

Features of Good Lighting

Proper senior care lighting should be energy efficient, while making the facility a comfortable and safe place to stay. Good lighting should decrease shadows, reflections and glare and create an easy-transition facility. Meaning, seniors shouldn’t have to adjust their eyes or feel discomfort when moving from room to room around the facility.

By decreasing shadows, reflections and glare, seniors will have less falls and accidents. Glare can cause the eye to not recognize obstacles such as chairs, tables and other objects. Shadows can also cause accidents and even anxiety. Shadows can sometimes be seen as a threat or mistaken for something else. This can lead to disorientation and agitation. Residents with dementia especially need proper lighting to reduce shadows on people’s faces. Shadows on nurse’s faces can make it difficult for the resident to recognize them, which can cause agitation and even aggression.

Different areas of the facility require different types of lighting. Staircases, corridors and recreation rooms require partial indirect lighting and must cast as few shadows as possible. Healthcare rooms should combine indirect and direct wall lighting. This features comfortable ambient lighting, to ensure patients are comfortable if they are lying down, and a direct light to ensure the care provider can examine properly, and the patient can read comfortably.

Bathrooms should feature a soft ambient light that also minimizes shadows. Many slips and falls occur in the bathroom when residents are getting in and out of the shower or bathtub, which makes it important to create a high-visibility environment. The low-shadow lighting also makes it easier to see the floor of the shower or bathtub they are getting in and out of. Vanity lighting also needs to be bright with proper color renditions—this improves the patients’ self-perception, which can have a direct reflection on their psychiatric wellness.

Seniors need high light levels, but increased light levels aren’t capable of fixing everything. Light quality is just as important. If the light is of poor quality, the levels might not even matter. Lighting cannot completely solve the issues that come with growing older, but good, quality lighting can help increase visual performance and increase residents’ quality of life.

This older population is growing, and with today’s technology we can tailor lighting to fit their needs. There are many factors in senior care facilities that can make them successful, but lighting in an easy and affordable way to improve the lives of residents while saving money on energy and maintenance costs. Families and friends will feel at ease knowing their loved ones are in a safe and well-lit environment.

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